title: Early paracetamol treatment associated with lowered risk of persistent ductus arteriosus in very preterm infants.
abstract: OBJECTIVE
  Persistent ductus arteriosus (PDA) delays the recovery of very preterm infants (VLGA, gestation <32 weeks). Indomethacin/ibuprofen treatment and ligation of PDA have complications. As a prostaglandin synthase inhibitor paracetamol may also promote the closure of ductus arteriosus. We studied retrospectively whether early paracetamol therapy was associated with decreased incidence of PDA without adverse events.
  
  
  METHODS
  On June 2009, we introduced intravenous paracetamol during early respiratory therapy. We included 105 VLGA infants who received paracetamol before the age of 72 h. The loading dose was 20 mg/kg followed by 7.5 mg/kg every 6 hours. The 96 VLGA infants admitted from January 2008 to May 2009 without lethal congenital disease were controls. Infants dying very early were excluded, leaving 102 paracetamol-exposed and 88 controls for analysis.
  
  
  RESULTS
  After the introduction of paracetamol, the incidence of PDA decreased from 30.7% to 14.7% (p = 0.008). Ibuprofen treatment was given to 15 paracetamol-treated and to 26 control infants (p = 0.013). Three paracetamol-exposed and seven control infants required surgery. There was no detectable increase in adverse events.
  
  
  CONCLUSIONS
  Annual incidence of PDA decreased after introduction of paracetamol. Efficacy and safety in promoting the early closure of ductus arteriosus remains to be established.
authors.affiliation: Department of Pediatrics, Oulu University Hospital , Oulu , Finland and.
authors.forename: Outi
authors.initials: O
authors.lastname: Aikio
authors.forename: Pia
authors.initials: P
authors.lastname: Härkin
authors.forename: Timo
authors.initials: T
authors.lastname: Saarela
authors.forename: Mikko
authors.initials: M
authors.lastname: Hallman
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D001724:Birth Weight; D004374:Ductus Arteriosus, Patent / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D012189:Retrospective Studies; D012306:Risk; D061665:Time-to-Treatment; D016896:Treatment Outcome
chemical_list: D000082:Acetaminophen; D007052:Ibuprofen
keywords: Acaetaminophen; intravenous; patent ductus arteriosus; premature